Stay on guard, U.S. warned / Top doctors worry Americans may develop false sense of security

Ceci Connolly, Washington Post

Published 4:00 am, Monday, April 28, 2003

Luck appears to be the one distinct advantage the United States has over many other countries affected by the unfolding medical mystery of SARS, several of the nation's top doctors said Sunday.

With just 41 confirmed cases of severe acute respiratory syndrome, U.S. medical officials worry that Americans might be lulled into a false sense of security. They cautioned that it would be dangerous to assume the contagious virus causing SARS will not still strike in larger numbers here.

As evidence, they pointed to two SARS hot spots -- Toronto and Hong Kong. In those cities, sophisticated medicine and strong public health systems -- on par with the expertise in major U.S. cities -- were not enough to contain the rapid spread of the disease.

"It is not under control right now," said Anthony Fauci, director of the infectious disease division of the National Institutes of Health. "The important thing is to get it under control and to prevent that domino effect of expansion from one contact to another, which we've seen in a very, very serious way in Hong Kong and other Asian countries."

The new respiratory ailment first appeared in southeastern China in November. Initial confusion about the strange pneumonia, followed by a huge effort by Communist Party leaders to conceal the outbreak, gave the virus a big jump on physicians in Asia and Canada. The early cases abroad and a mid- March alert by the World Health Organization put the United States in a better position to respond.

"We were fortunate enough to be just ahead of the curve," Fauci said on ABC's "This Week."

Experts believe SARS is transmitted most easily through close human contact,

often from sneezing or coughing. But some laboratory analysis and several cases suggest it may survive on surfaces for several hours, making it possible to spread the germ simply by touching objects.

In Hong Kong and Toronto, medical workers have been hit hard by the disease and health systems are in danger of being overwhelmed, said Jeffrey Koplan, an Emory University physician who just spent a week in Hong Kong.

"No matter how talented the health workers are and what resources are available, an event like this quickly taxes it to the extreme," said Koplan, who was Gerberding's predecessor at the CDC. "There is nothing that has happened in Toronto that couldn't happen anywhere in the United States."

Fauci and Koplan expressed concern over the many unknown aspects of SARS, particularly how it can be spread, how long individuals are contagious, and whether someone can transmit the virus without displaying symptoms. Those uncertainties have meant that in Hong Kong, virtually every patient arriving at a hospital is treated as a potential SARS case, which reduces the chances of missing SARS carriers but adds to the burdens on doctors and nurses.

Worldwide, SARS appears to have killed about 6 percent of those known to have been infected, Gerberding said. SARS has infected more than 4,800 people and killed more than 300, according to the latest figures collected by the World Health Organization. U.S. officials are monitoring more than 200 possible cases.